Bone and Joint infection (3 questions)

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Bone and Joint infection (3 questions)
2013-11-06 18:24:45
Vuong questions

PT III exam
Show Answers:

  1. what is osteomyelitis
    inflammatory process accompanied by bone destruction and caused by an infecting organism
  2. clinical presentation of bone and joint infection
    • pain in affected area
    • swelling 
    • fever 
    • chills 
    • decrease motion
  3. what are the most important tools in obtaining cultures
    • isolate offending organism
    • bone biopsy
    • blood cultures
    • fluid culture
  4. what is contiguous infection
    reaches bone from adjoining soft tissue infection or direct inoculation
  5. how does a contiguous infection normally occur
    • trauma
    • bone surgery 
    • joint replacement
  6. which comorbidity is usually associated with vascular insufficiency
  7. what are the bones affected in hematogenous infections
    • children; long bones -- tibia, femur
    • adults; vertebral
  8. how is vertebral infection diagnosed
    needle biopsy
  9. likely organisms for newborns
    • s. aureus
    • strep
    • e. coli
  10. likely antibiotic treatment for newborns
    naf/oxacillin and cefotaxime
  11. likely organisms to infect children <= 5 years of age and what antibiotics are used to treat
    • s. aureus
    • strep

    naf/oxacillin or cefazolin
  12. likely organisms to infect children > 5 yrs of age and what antibiotics are used to treat them
    s. aureus

    naf/oxacillin or cefazolin
  13. regular adults with bone/joint MMSA infection should be treated with
    naf/oxacillin or cefazolin
  14. regular adults infected with p. aeruginosa should be treated with
    cipro or ceftazidime +- tobramycin
  15. postoperative adult patients should be treated with
    • naf/oxacillin or ceftazidime/cefepime
    • or 
    • ticarcillin-clavulanate
  16. patients with vascular insufficiency should be treated with
    • naf/oxa or cefazolin
    • PLUS
    • ceftazidime/cefepime
  17. MRSA IV antibiotics
    • daptomycin
    • linezolid
  18. MRSA oral antibiotics
    • clindamycin
    • linezolid
    • doxycycline
    • bactrim with rifampin
  19. what is the min amount of tx for MRSA bone joint infection
    8 weeks
  20. duration of therapy for non MRSA acute and chronic bone and joint infections
    • 4 - 6 weeks (acute)
    • 6 - 24 weeks (chronic)
  21. which pts cannot receive oral antibiotic therapy
    adults with diabetes or PVD
  22. what is the basic rule for patients with prosthetic joint infection
    remove the device in 2 stage exchange
  23. what are the most common microorganisms for immunocompromised patients
    • aspergillus
    • c. albicans
    • mycobacteria
  24. spreading of which diseases can cause septic arthritis
    • osteomyelitis 
    • hematogenous
    • direct inoculation
  25. what is the appropriate duration of therapy for nongonococcal septic arthritis
    2 - 3 weeks
  26. what are the important therapeutic maneuvers for septic arthritis
    • appropriate abx
    • joint drainage
    • joint rest
  27. what is the tx of choice for gonoccocal infection
    • ceftriaxone 7 - 10 days
    • may change to amoxicillin or doxycycline